Example orders for 5-FU & high-dose Leucovorin (Roswell Park regimen - HDLV) in colon cancer

Remember that example order sets that may contain additional information about supportive medications, suggestions for monitoring, hydration, and pre-treatment screening information for chemotherapy regimens are purely anecdotal, provided only as examples of what some other providers may be using, and are typically not based on references in the primary literature.

5-FU & high-dose Leucovorin (Roswell Park regimen/HDLV)

Original references may be found at 5-FU & high-dose Leucovorin (Roswell Park regimen/HDLV) (adjuvant) & 5-FU & high-dose Leucovorin (Roswell Park regimen/HDLV) (metastatic)

Example regimen #1

• Folinic acid (Leucovorin) 500 mg/m² IV over 2 hours on days 1, 8, 15, 22, 29, 36, given first
• Fluorouracil (5-FU) 500 mg/m² IV push on days 1, 8, 15, 22, 29, 36, 1 hour after start of leucovorin

8-week cycles x 3-4 cycles for adjuvant therapy; in metastatic settings, given until progression of disease or unacceptable toxicity

Supportive medications

• Prochlorperazine (Compazine) 10 mg PO once - 30 minutes prior to chemotherapy
• Ondansetron (Zofran) 8 mg IV prn nausea
• Dexamethasone (Decadron) 10 mg IV prn nausea

Hydration:

• 500 ml NS at KVO rate as running IV for chemotherapy infusion. Give up to 500 ml NS.

Monitoring:

• Hold if patient has significant diarrhea/mucositis, ANC <1000, or platelets <100 and notify physician.